Abstract
Seventeen oncological patients with different tumours were investigated by means of 18fluorodeoxy-D-glucose (FDG) positron emission tomography (PET) for primary staging and restaging after therapeutic interventions. Patients also underwent other staging procedures, including serum tumour marker level determination, radionuclide planar scintigraphy and radiological investigations (ultrasonography, computed tomography and magnetic resonance imaging). The results of different imaging methods in the search for metastatic lymph nodes (LNs) were reviewed. To check the applicability of FDG PET for estimation of the proliferative capacity of the tumours, a comparison was carried out of the patients’ history, results of DNA analysis of the tumour cells and the FDG uptake as measured by PET. FDG PET proved to be superior to conventional imaging methods in staging tumours by the determination of metastatic LNs. Staging by PET was more effective for tumours in the case of LNs localised to the mediastinum (12 cases), the deep (paratracheal and paraoesophageal) cervical (5 cases), the axillary (2 cases), the supraclavicular (1 case) and the iliac regions (1 case). DNA analysis was performed in 14 cases. A direct correlation was found in all but one case between the tumour (LNs) to background FDG uptake ratio (TBUR) and the S-phase proportion of the tumour cells: high (>5) TBUR values were associated with a high (>10%) S-phase proportion, while cases with TBUR ≤5 involved an S-phase fraction of ≤10%. In the 14th case the tumour was aneuploid and a high TBUR value coincided with a low (1%) S-phase proportion. Patients with LNs displaying high TBUR and high S-phase ratio values have a greater chance of developing distant metastases (3/4 cases) than those with low values of both parameters (3/9 cases). An additional advantageous feature of FDG PET is that it can provide individual patient prognoses via estimation of the proliferative capacity of metastatic LNs.
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References
Barlogie, B., Raber, M.N., Schumann, J., Johnson, T.S., Drewinko, B., Swartzendruber, D.E., Göhde, W., Andreeff M. and Freireich, E.J. (1983) Flow cytometry in clinical cancer research, Cancer Research 43, 3982–3997
Crowe, J.P. Jr., Adler, L.P., Shenk, R.R. and Sunshine, J. (1994) Positron emission tomography and breast masses: comparison with clinical, mammographic, and pathological findings, Ann. Surg. Oncol 1, 132–140.
Ésik, O., Márián, T., Gulyás, B., Tóth, E., Lövey, J. and Trión L. (1996) FDG PET investigations in medullary thyroid cancer, in A.M.J. Paans, J. Pruim, E.J.F. Franssen, W. Vaalburg (eds.), Proceedings of the European Conference on Research and Application ofPositron Emission Tomography in Oncology, Groningen, p. 137.
Ésik, O., Gulyás, B., and Trón, L. (1996) Diagnosis, differential diagnosis, and follow-up of tumours by means of FDG PET, in B. Gulyis and H.W. Müller-Gärtner (eds.), Positron emission tomography: a critical assessment of recent trends, Kluwer Academic Publishers, Dordrecht, this volume
Haberkom, U., Strauss, L.G., Reisser, C., Haag, D., Dimitrakopoulou, A., Ziegler, S., Oberdorfer, F., Rudat, V. and van Kaick, G. (1991) Glucose uptake, perfusion, and cell proliferation in head and neck tumours: relation of positron emission tomography to flow cytometry, J. Nucl. Med 32, 1548–1555.
Hoh, C.K., Hawkins, R.A., Glaspy, J.A., Dahlbom, M., Tse, N.Y., Hoffman, E.J., Schiepers, C., Choi, Y., Rege, S., Nitzsche, E., Maddahi, J. and Phelps, M.E. (1993) Cancer detection with whole body PET using 2[18F]fluoro-2-deoxy-D-glucose, J. Comput. Assist.Tomogr 17, 582–589.
Leskinen-Kallio, S., Nâgren, K., Lehikoinen, P., Routsalainen, U., and Joensuu H. (1991) Uptake of 11Cmethionine in breast cancer studied by PET. An association with the size of S-phase fraction, Br. J. Cancer 64, 1121–1124.
Minn, H., Joensuu, H., Ahonen, A. and Klemi, P. (1988) Fluorodeoxyglucose imaging: a method to assess the proliferative activity of human cancer in vivo. Comparison with DNA flow cytometry in head and neck tumours, Cancer 61,1776–1781.
Miyazawa, H., Arai, T., Iio, M. and Hara, T., (1993) PET imaging of non-small cell lung carcinoma with carbon-1 l-methionin: relationship between radioactivity uptake and flow-cytometric parameters, J. Nucl. Med 34, 1886–1891.
Nieweg, O.E., Kim, E.E., Wong, W.H., Broussard, W.F., Singletary S.E., Hortobagyi, G.N. and Tilbury, R.S. (1993) Positron emission tomography with fluorine-18-deoxyglucose in the detection and staging of breast cancer, Cancer 71, 3920–3925.
Reisser C., Haberkom U. and Strauss L.G. (1993) The relevance of positron emission tomography for the diagnosis and treatment of head and neck tumours, J. Otolaryngol. (Canada) 22, 231–238.
Szentinnay, Z., Tusnidy, G., and Toth, E. (1997) A daganatok koros DNS tartalma [Cellular DNA content of human tumours, in Hungarian], Orvosi Hetilap 138, 000–000.
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Lövey, J., Ésik, O., Gulyás, B., Tóth, E., Molnár, T., Trón, L. (1998). Evaluation of Metastatic Lymph Nodes by Means of FDG PET. In: Gulyás, B., Müller-Gärtner, H.W. (eds) Positron Emission Tomography: A Critical Assessment of Recent Trends. NATO ASI Series, vol 51. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-4996-9_18
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DOI: https://doi.org/10.1007/978-94-011-4996-9_18
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